Health and Care Services

Debate between Andrew Percy and Phillip Lee

Wednesday 3rd July 2013 Commons Chamber

[Dr Lee]

I am pleased that services are improving in County Durham; as the hon. Gentleman knows, I have family roots in his part of the world that go back centuries. I am not persuaded of the role of pharmacies, although I am persuaded of the role of pharmacists. I distinguish between the two because I personally think that all GP surgeries should be dispensing drugs. I do not see why the taxpayer should be subsidising pharmacies.

It is no surprise to me that Boots was the biggest ever private equity buy-out in the history of British industry, given that the taxpayer is outside the front door: “Come here for your amoxicillin, and while you’re here you can get your shampoo, conditioner and royal jelly.” I am not convinced about the role of pharmacies in the longer term; pharmacists most certainly have a role and should be included. Community pharmacists should be checking drugs, particularly when patients have polypharmacy—when they have a multitude of medications, another pair of eyes is always appropriate.

To return to the reconfiguration, in my locality we have a number of district general hospitals. Historically, Bracknell itself has been under-served by acute services since it was created in the late ’50s or early ’60s. We have seen services diminish in the area for a variety of reasons and under Governments of both parties, and we are sensitive about that.

Before I was elected as Member of Parliament for Bracknell—I stress that it was before I was elected—I suggested as part of my campaign that we needed to close hospitals in the area and consolidate to improve clinical outcomes. I am not aware that my result at the election was adversely impacted by that. Having worked in the area as a GP for a number of years and looked after 50,000 patients, I guess that people trusted what I was saying, and I recognise that.

I was trying to argue that we could consolidate acute services on a single site and improve community hospital services in appropriate locations around the region. I stress the word “appropriate”, as the problem is often that, for a variety of legacy reasons, hospitals are in inappropriate locations. They are not often on motorways, but on land bequeathed before the war. In my part of the world, the Astor family bequeathed the land for Heatherwood hospital. The local farmer outside Slough bequeathed some land because his daughter was looked after well. People thought, “Okay, we’ll build a hospital in the middle of a farm field nowhere near the population that it seeks to serve.”

There is a legacy problem. There is some need to close and relocate, while in some parts current locations can be enhanced. In my locality, there is the problem with Heatherwood hospital. I must put on the record something bizarre that frustrates me. It is “blue on blue”; if I was in a defence debate, it would be called friendly fire. The Royal Borough of Windsor and Maidenhead has called for a judicial review of the relocation of a minor injuries unit just three miles down the road, would you believe, to Bracknell—an urban centre in a better location and away from a place opposite the Royal Ascot racecourse. That judicial review will delay the move and cost money. I find that baffling and bizarre. It is evidence of the problem that I guess all colleagues of both political colours experience in local politics with regard to health care and trying to change services for the improvement of clinical outcomes, because it is not about cost, although obviously that is a factor, but about improving clinical outcomes. That frustrates me, and I will certainly be dealing with it robustly in local terms. At the moment, it is in the best interests of the general public to have fewer acute hospitals.

[Andrew Percy (Brigg and Goole) (Con)]

My hon. Friend is making an interesting point. Does he agree that in applying solutions such as those he is espousing, we must be careful that we do not apply an urban solution to rural areas? Moving an A and E three miles might be acceptable, but moving it 30 miles would not be acceptable to a lot of us.

[Dr Lee]

My hon. Friend is right: in a rural location the distances become further. I do not know the particular situation in his region, but I would suggest that there are probably location issues with regard to existing hospitals.

Moving neatly on, that is why—yes, you heard it here first: a Conservative calling for a Soviet-style central plan—I have called for a national plan for acute and emergency care. By definition, we cannot have a market interfering in that; we need to look at it in the round and say, “Where would we put these hospitals? Where are the motorways? What is the population density? Where is the rural location? Where is the urban location?” The problem is that if we reconfigure in isolation—I have seen this locally—it has a knock-on effect on other hospital services which then say, “Where are we getting our patients from?”

We should have a national plan that everyone from both parties has bought into. We should have—dare I say it?—a cross-party party committee looking into this. We should take it out of the political exchanges that we all engage in. We know what is going to happen in certain quarters in 2015—it will become a political football. I know that my hon. Friend the Minister is very aware of this. That is dreadful when we are talking about saving lives. Let us try to take this out of party politics. We can have robust exchanges, on principle, about payment, about how services are commissioned or not commissioned, and about whether there should be top-down reorganisation, but the fundamental question of where hospitals—acute and community hospitals—are located should be decided nationally; otherwise we could have perverse decisions whereby some services wither on the vine and we end up with gaps in emergency and acute care across the country. I make a plea for some cross-party activity on this.

Let us put the national health service’s budget into context. This country has debts and liabilities in excess of five times the size of our economy, and the situation is getting worse. Almost 40% of spending is on health and welfare, and it is growing. We know that that will happen; we have heard it this afternoon. Let us be realistic: there is only so much we can afford. I genuinely want a service that is based on clinical need. I genuinely want somebody to arrive at the appropriate location and get the very best care available. I fear that if we continue along this path of denial as regards how the service is paid for and, more important, structured, we will end up with more and more scandals. There are more in the pipeline. The chief executive of Tameside hospital has just resigned.

The public out there want more from us. They want us to make some difficult decisions, for sure, but using evidence, not party politics. I make that plea to everybody. If we can do that, we can structure a service that becomes the envy of the world; it is not that at the moment. However long I end up staying in this House, if that is achieved in the time I have been here, I will retire a happy man.